Micro

Question 1

LCMV Name
Genome?
Enveloped/Naked?
Causes what?

Answer 1

Lymphocytic Choriomeningitis Virus
Arenavirus: ambisense, RNA, enveloped
Causes febrile, aseptic choriomeningitis

Question 2

Groups of bacteria causing meningitis:

Answer 2

Pneumococcus
Group B Strep
Meningococcus
H. influenzae

Question 3

4 Classic Symptoms of Meningitis:

Answer 3

• Headache
• Stiff Neck
• Fever
• Photophobia

Question 4

Neisseria meningitidis:
gram \_\_\_
\_\_\_\_cellular
Oxidase \_\_\_
Catalyse \_\_\_
Ferments\_\_\_

Answer 4

Gram (-)
Facultative intracellular
Oxidase (+)
Catalyse (+)
Ferments Glucose and Maltose

Question 5

Difference of pathogenic vs. non-pathogenic N. meningitidis strains:

Answer 5

Pathogenic = Encapsulated (polysaccharide)

Question 6

Neisseria needs ___ agar to grow

Answer 6

Chocolate agar

Question 7

N. meningitidis is:
Transmitted by ____
Colonizes ____

Answer 7

Airbone droplets

Nasopharynx (asymptomatic carriage)

Question 8

Most common N. meningitidis age range:

Answer 8

2-18 years

Question 9

3 major N. meningitidis virulence factors

Answer 9

• Polysaccharide Capsule
• IgA Protease
• LOS

Question 10

Lack of what complement proteins increases risk for N. meningitidis

Answer 10

C5-9

Question 11

Waterhouse-Friderichen Syndrome:

Answer 11

• Bilateral destruction of adrenal glands

- DIC

Question 12

What can’t you give for N. meningitides?

Answer 12

Glucocorticosteroids

Question 13

Group B Strep
Capsule?
Gram ___
___ Hemolytic

Answer 13

• Encapsulated
• Gram (+)
• Beta-hemolytic

Question 14

Major risk group for GBS+ meningitis?

Why?

Answer 14

• Neonates

- GBS is natural flora in the vagina

Question 15

CAMP test:

Answer 15

B-hemolysin of S. aureus interacts w/ GBS to cause enhanced hemolysis

Question 16

Hippurase test turns what color?

Answer 16

Purple

Question 17

2 Ways to differentiate GBS and Listeria in a CSF sample

Answer 17

• Morphology on gram stain (cocci vs rod)

- Motility on wet mount

Question 18

Pneumococcus:
Gram ___
Catalase ___
___ Hemolytic

Answer 18

• Gram (+)
• Catalase (-)
• Alpha-hemolytic

Question 19

Strep pneumonia is most common cause of community-acquired: (4 things)

Answer 19

• Pneumonia
• Bacterial meningitis
• Bacteremia
• Otitis media

Question 20

Pnemococcus causes a (low/high) inflammation meningitis

Answer 20

High

• Strong inflammatory response
• All pathogenic strains produce a pneumolysin

Question 21

Pneumococcal disease also requires what kind of testing?

Answer 21

Antibiotic-sensitivity testing

Question 22

1st line Pneumococcus meningitis treatment is ___

If resistant, add ___

Answer 22

Vancomycin + ceftriaxone or cefotaxime

Resistant: add rifampin, meropenem or chloramphenicol

Question 23

For which septic meningitises can you use corticosteroids?

Answer 23

Pneumococcal

Question 24

3 routes of viral entry into CNS

Answer 24

1. Neural
2. Olfactory
3. Hematogenous

Question 25

80% of viral meningitis caused by:

Answer 25

Enterovirus

Question 26

Brudzinski's sign is:

Answer 26

- Guarding due to nuchal rigidity | - Neck raise --> leg raise

Question 27

Distinguishing feature of encephalitis not found in meningitis

Answer 27

Encephalitis: intracerebral hemorrhage

Question 28

What is ADEM? When? What causes?

Answer 28

- Acute Disseminated Encephalomyelitis - postinfectious encephalitis (after VIRAL infection) - 1-2 weeks later - Autoimmune disorder

Question 29

Herpes simple encephalitis usually affects what part of the brain?

Answer 29

- Temporal lobe | - Unilateral

Question 30

When do you immunize someone for rabies?

Answer 30

- Post-exposure | - Prevents spread up into the brain

Question 31

What is Pachymeninges | What is Leptomeninges

Answer 31

Pachy: outer layer, dura Lepto: inner layer, arachnoid, dura

Question 32

Lumbar Puncture CSF Findings in Bacterial vs Virus vs Fungal meningitis

Answer 32

Bacterial: high Neutrophils, low glucose Viral: high Lymphocytes, normal glucose Fungus: high Lymphocytes, low glucose

Question 33

What do you have to worry about in terms of meningitis post-surgery?

Answer 33

Anaerobic bacteria

Question 34

Clinical feature that distinguishes Meningitis vs Encephalitis

Answer 34

MENTAL STATE confusion and/or decreased level of consciousness -->encephalitis

Question 35

Pus in ____ (space) in acute bacterial meningitis

Answer 35

Subarachnoid space

Question 36

3 Complications of Bacterial meningitis:

Answer 36

1. Spreading to infect Virchow-Robbins (perivascular) space 2. Thrombosis of leptomeningeal vessels 3. Hydrocephalus (communicating or obstructive)

Question 37

What kind of cell makes the BBB?

Answer 37

Astrocyte glial cells

Question 38

"Worst headache in my life"

Answer 38

DDx: ruptured aneurysm

Question 39

What kind of meningitis is usually self-limiting?

Answer 39

Aseptic (viral) meningitis

Question 40

What is PML? What causes it? What can it be confused for

Answer 40

- Progressive Multifocal Leukoencephalopathy - Viral by JC polyomavirus - Can mimic MS

Question 41

3 Major Patterns of Fungal Meningoencephalitis:

Answer 41

1. Chronic Meningitis 2. Vasculitis 3. Parenchymal invasion

Question 42

What 2 fungi are usually associated w/ vasculitis

Answer 42

Mucor (especially diabetics) | Aspergillus

Question 43

What 2 fung are usually associated w/ brain invasion?

Answer 43

Candida | Cryptococcus

Question 44

Rabies asociated w/ this animal

Answer 44

BATS!

Question 45

Rabies encephalopathy pathopnemonic finding:

Answer 45

Negri bodies in brain

Question 46

HIV encephalopathy has what finding:

Answer 46

Giant cells

Question 47

Vasculitis meningitis can cause what superficial finding?

Answer 47

Petechial hemorrhages